MOBBING IN NURSING: AN INTEGRATIVE REVIEW

Introduction: Mobbing is a phenomenon in which aggressors (hierarchical superiors, colleagues or subordinates) repeatedly humiliate and debilitate their victims with the purpose of demeaning and undermining them. This behavior affects the victims’ physical and psychological health and deteriorates their personal and professional life, being considered an emerging psychosocial risk. Nursing, as a mostly female profession, can be particularly vulnerable to its occurrence.
Objective: This study aimed to gather and synthesize the results of studies on mobbing in nursing in Latin-American countries which have been published in the past six years.
Methodology: An integrative literature review was conducted. A search was performed in BVS using the keywords “mobbing”, “assédio moral” (moral harassment), “harassment”, “bullying at work”, “acoso moral”, and “enf*”.
Results: Six descriptive and exploratory articles were identified and analyzed. The prevalence of mobbing ranged from 11.5% to 33.3%. Both physical and psychological consequences were reported.
Conclusion: Mobbing is a recognized problem in many professional settings, namely in nursing. Its impact on the workers’ health and the quality of the workplace environment has been identified. However, these studies have not focused on analyzing preventive or restorative measures to stop these harmful practices.

THE RELATIONSHIP BETWEEN HABITUAL HANDLING MONEY NOTES AND INFECTIOUS-CONTAGIOUS DISEASES

Objective: To analyze the eventual relationship between infectious diseases and individuals who have habitual professional contact with money notes.
Methods:This is a cohort study, retrospective, observational, analytical, non-randomized. Individuals working with habitual manipulation of money notes were included in the group “exposed” group and compared to “non-exposed” group. The infectious diseases analyzed were those of respiratory, gastrointestinal and ophthalmological origin.
Results:There were 603 cases in “exposed” group and 752 in “non-exposed” group. There was no statistically significant difference in the number of medical certificate and total days lost due to infectious disease in both groups (p = 0.3197 and p = 0.0954, respectively). In the “exposed” group, the relative risk for medical leave due to infectious diseases of gastrointestinal origin was 1.131 (95% CI 0.865 to 1.479, with p = 0.366), ophthalmologic 0.769 (95% CI 0.517 to 1.1421, with p = 0.191) and respiratory 0.735 (95% CI 0.572 to 0.9456, p = 0.015).
Conclusion:The usual contact with money notes did not increase the risk of medical licenses for infectious diseases.

COMPUTER VISION SYNDROME IN OFFICE WORKERS

Introduction
Computer users report a sensation of tired eyes, blurred vision or even constant headache- these symptoms can result from a new ophthalmological disease: the visual computer syndrome.
Objectives
This integrative bibliographical review intends to summarize the concept of this “new ophthalmological disease” and to know the impact for the constant users of the computer in the workplace.
Methodology
It is an integrative review of the literature, according to the PCC methodology (participants, concept and context), in which a bibliographic research was carried out between May 28 and June 1, 2018 in the Medline/ PubMed, EBSCO and RCAAP, using the descriptors “computer”, “workers”, “vision” and “ergonomics”.
Results
We identified 16 results, from which we selected 3 final documents for extraction and analysis. The results showed, in all the studies, a high prevalence of Visual Computer Syndrome. In a study carried out in Sri Lanka, with a population sample of 2210 workers, a prevalence of 67.4% was observed. Differences between studies are observed regarding the symptoms of Visual Computer Syndrome presented by the workers, being able to be related to the characteristics of each sample, as well as the different instruments used to evaluate them.
Conclusions
In computer users, the eyes tend to shift focus to a resting point and then focus on the monitor again. These workers look at the computer monitor for hours, which emphasizes the eye muscles, leading to symptoms such as eye fatigue and discomfort, causing headaches, symptomatology characterized by Visual Computer Syndrome. There is a need to conduct studies on the impact of Visual Computer Syndrome on workers’ health and on preventive strategies.

OVERVIEW OF VETERINARY SECTOR OCCUPATIONAL H

Introduction / framework / objectives: Veterinarians and their collaborators (Veterinarian Nurses and Auxiliaries) are subject to numerous occupational hazards. The objective of this study is to characterize their perception regarding the existence of occupational risk and risk factors, their use of personal protective equipment, susceptibility to occupational accidents and diseases, exposure to work stress and the use of occupational health team.
Methodology: This is a descriptive, cross-sectional study, carried out after the application of an online survey, using a sampling technique for convenience, with the collaboration of associations, veterinary clinics, as well as some companies of occupational health. Data collection took place between June 2017 and March 2018 and the final value of the sample represents the number of veterinarians, veterinary nurses and auxiliaries working in veterinary clinics / hospitals who have volunteered to respond anonymously and voluntarily to the survey.
Results: Ninety-one individuals responded and 90 surveys were validated (one was eliminated because of incoherence of responses). The sample consisted mainly of female workers (87.8%), under the age of 30 (53.3%), with little professional experience (53.3% worked for less than 5 years) and predominant profession in veterinary medicine (80.0%). Risk factors include contact with immunoallergenic products, stress, handling of chemicals and biological risk in contact with animals. The use of uniforms and a mask is particularly important for personal protective equipment. The existence of a personal history of occupational accidents is very frequent (93.3%), and animal injuries such as nibbling, scratching or abrasions are very prevalent, followed by bites or cuts with potentially contaminated sharp objects. However, there were few cases where there were functional limitations. At the level of occupational diseases, the musculoskeletal lesions (26.7%) stand out, although only one case has been declared as a suspected occupational disease. Stress emerged as a very frequent phenomenon, affecting almost all workers (96.7%), especially the difficulty in reconciling professional and personal lives (81.1%), wage dissatisfaction (76.7%) and the high workload (73.3%). Finally, it is observed that the majority (63.2%) have a work medicine consultation at least every two years, but only 28.9% perceive the work performed by the Technician of Hygiene and Safety and only 26.7% report having workshops related to their occupational hazards.
Conclusion:A small sample of 90 individuals divided into three professional classes with distinctive characteristics and questions that failed to cover all the possible answers may have biased the results of the statistical treatment; because if in some situations relationships were found between variables consistent with the occupational bibliography for most of the professions and in line with the authors’ clinical experience, in other cases the opposite occurred. Among the several statistical relationships highlighted, the associations between female sex, stress and the general existence of symptoms associated with work, as well as the associations between exercising as a veterinarian, feeling occupational stress due to conflict with clients and being exposed to cut / chop accidents with potentially contaminated objects. This study served as a starting point for a first summary characterization of this sector, and a larger study with broader and better structured questions is obviously desirable.

THE IMPACT OF SHIFT WORK IN OCUPACIONAL STRESS OF NURSES – INTEGRATIVE REVIEW

Introduction: Occupational stress, due to its importance and magnitude, is considered a true public health problem. Nursing was classified by Healthy Education Authority as the fourth most stressful occupation in public health.
Objectives and Methodology: Our study is focused on the impact of shift work in occupational stress on nurses, through an integrative review of the literature, using the PI[C]OD methodology. After applying the inclusion and exclusion criteria, we were based on four articles.
Results: The articles analysed have studied different variables through different models/questionnaires. The articles mentioned a higher level of occupational stress in nurses working rotating shifts when compared with those who have a fixed schedule. Nurses who work rotating shifts, have a greater difficulty in dealing with stress factors, have a higher overcommitment with work and an effort/reward imbalance. Changes in their sleep-wake pattern, due to the interference in the circadian cycle, have not only physical consequences but also in their work performance.
Conclusions: Although it is not possible to finish with shift work in nursing, we have verified that through adequate organizational planning of schedules and with the implementation of specific measures it is possible to decrease the occupational stress of nurses working in shifts. Thus, there is a need for more research, particularly in the Portuguese population, so that it is possible to develop guidelines/legislation to guide the preparation of shift schedules for Portuguese Nurses, to reduce occupational stress and provide better health levels, less working absenteeism, lower costs in health and better patient care.

Introduction: Professionals working in the operating rooms of the University Hospitals of Central Lisbon, CHULC, EPE are exposed, according to their activities to residual halogenated gases (Sevoflurane/ Desflurane) either alone or in combination with Nitrous Oxide (N2O). All the operating rooms in these hospitals have decontamination, ventilation, exhaustion and conditioning systems according to the Portuguese Standards NP 1796/2014 and the Central Administration of Health System (ACSS).
Materials and Methods: This article is a retrospective study consisting of the analysis of all the environmental assessments carried out by the Occupational Health Services between 2013 and 2017 at CHULC, EPE, to verify if the working conditions were adequate and the occupational exposure was below the limit values. Using a multigas analyzer (infrared spectroscopy), 131 evaluations of waste anesthetic gases and air quality were performed during these five years. Subsequently, the potentially exposed population, workers allocated to the operating rooms from 2013 to 2017, were identified through the human resources database.
Results and Discussion: 859 professionals were assigned to work in the operating rooms (that is an average of 610 professionals / year). On average, six professionals were present per surgery. During the length of this study, 52% (447) of these professionals were continuously exposed to this risk factor. Furthermore, out of the evaluations performed, 12% (16) had an average of exposure above the limit, all of which related to Sevoflurane/Desflurane. The causes for these elevated exposures were divided into two categories, the first represented by the failures in the ventilation system and extraction of the operating rooms and a second one consisting of failures in the anesthetic equipment. Nevertheless, the results showed that in the majority of the evaluated situations the professionals were exposed to levels below the recommended exposure limits ??for the halogenated agents (Sevoflurane/Desflurane) and in 100% of the measurements concerning N2O concentrations and CO2 concentrations in the operating rooms.
Conclusion: The results show that, despite the existence of the risk of occupational exposure to inhaled anesthetic gases, there are safety measures that minimize the hazards, for example, the existence of a maintenance program that guarantees the proper functioning of the ventilation/ extraction system in operating rooms and ventilators. When there is a non-compliance in those measurements, it is usually associated with failures in one of the systems, and when the failure is diagnosed and corrected, the values return to normal standards.

OCCUPATIONAL HEALTH APPLIED TO WORK IN A CONFINED SPACE

Introduction / framework / objectives: Confined space is defined as an area of small size, but to the extent that it allows the total entry of at least one employee and the respective execution of work tasks, however, there are limitations on entry and exit and without the possibility of work at full time and continuously. Work with these characteristics is usually associated with high risks, and it has been considered pertinent to carry out an exploratory bibliographical research to gather information capable of generally orienting occupational health teams that contact workers whose activity is restricted to confined spaces.
Methodology: This is an Integrated Bibliographic Review, carried out through a survey conducted in August 2018 in the databases “CINALH plus with full text, Medline with full text, Database of summaries of effects reviews, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: Comprehensive, Medication, Complete Academic Research and RCAAP.
Content
Nine articles were selected for review. Some confined spaces include tanks, boilers, sewers, submarines, pipelines, exhaust/ ventilation systems and tunnels. Part of the accidents that occur results in the death of one or more workers. In the review it is possible to enumerate several risk factors/ risks, measures of collective and individual protection, although it is estimated that there are others whose limitations of the research have failed to show.
Conclusions: The objective of the authors was to produce an integrative bibliographical review regarding the generality of risk / risk factors that could be found in confined space work; however, in addition to the bibliography being very scarce, most of the articles selected address particular and specific situations, not allowing to describe a complete overall picture. Likewise, since the activities carried out in confined spaces are very diverse and the bibliography consulted was scarce in terms of listings of risk factors, risks, collective and individual protection measures, the authors summarized these data and attempted to complete them in the measure of their generic experience.
The publication of further studies, as well as conducting investigations of specific occupational sectors, representing the national reality above all, would be important for improving knowledge about health promotion and accident prevention.

OCCUPATIONAL HEALTH APPLIED TO HYPERBARIC WORK

Introduction / framework / objectives: Scuba diving as a professional task will involve working in diving lessons, tourism, shipbuilding, maintenance of maritime platforms, researcher (biology, climatology, archeology, history, being a fisherman or plant collector.
Methodology: This is an Integrative Bibliographic Review, initiated through a survey conducted in August 2018 in the databases “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina, Academic Search Complete and RCAAP “.
Content: Barotrauma is the damage that arises in tissues as a function of pressure; this is avoided if homogenization of the pressure of the air pockets and the environment occurs. If this does not occur, serohematic transudation or even bleeding into the pneumatized cavities may occur to normalize the pressure. Going to the surface, the air expands in the pneumatized cavities and if this excess volume of air is not released, barotrauma will also result. Barotraumatism can thus exist in the ascent, although in the middle ear, for example, it is more frequent in descent.
The body’s response to the pressure difference will depend on its constitution: solid, liquid or gas.
Conclusions: In none of the consulted documents was a complete view of occupational health applied to this sector, although some of the studies are very exhaustive in the physics of diving and their physiological alterations, mainly associated with barotraumatism and decompression sickness. With this review and reflection the authors tried to list the risks / risk factors and measures of protection.

EVALUATION OF WORK CAPACITY VERSUS AGING OF EMPLOYEES, IN A PORTUGUESE MUNICIPALITY OF AVERAGE DIMENSION

Introduction: Europe’s working population is aging, and a number of organizations have consistently defined the category of workers over 55 as “Older Workers” in a context where, in the short / medium term, their productive capacity will be fundamental for several countries.
Objective: In order to understand the implications of this change for occupational health, it is intended to: a) characterize the population of older workers in a municipality in Portugal with respect to their capacity for work; b) comparing a sample of older workers with another sample of workers aged less than 35 years.
Method: This is a descriptive, correlational, comparative cross-sectional study, carried out after the application of a survey of workers in Albufeira municipality, with 1301 individuals. To obtain the final sample, the age-stratified sampling method was used. The study was authorized by the municipal responsible and the workers’ participation complied with all ethical requirements.
Results:The sample of Older Workers is less educated, has less differentiated jobs and maintains gender balance, something that does not happen in the younger ones where the females are more prevalent.
When comparing work capacity, there is an increase in morbidity and disability in the older age group, as well as a more negative feeling associated with the current intrinsic capacity, the capacity to face the demands of the task, and the available psychological resources. There is also a higher rate of long-term absenteeism and limitations in sensory perception (visual and auditory) that affect work capacity, factors that put them in a situation of greater vulnerability towards the Young Workers.
As far as the environment and interpersonal relationships are concerned, they believe that the employer values less their work than the other rest, and they are the only ones who report the existence of bad or very bad working environments. However, they do not present many suggestions for improvement.
Regarding the idealize retirement age, it exists a direct relationship with work ability (assessed with the WAI- work ability index) although they seem to be poorly informed about measures that could potentially facilitate and promote their physical and mental health, as well as their working capacity. However, they suggest increasing the number of holidays/ days off as facilitators.
Conclusion: The study concluded that there are statistically significant differences in almost all the areas analyzed, with detriment to older workers. It is therefore urgent to rethink new solutions in order to ensure in the future the maintenance of its productive capacity in a healthy and lasting way.

EVALUATION OF WORK CAPACITY VERSUS AGING OF EMPLOYEES, IN A PORTUGUESE MUNICIPALITY OF AVERAGE DIMENSION

Introduction: Europe’s working population is aging, and a number of organizations have consistently defined the category of workers over 55 as “Older Workers” in a context where, in the short / medium term, their productive capacity will be fundamental for several countries.
Objective: In order to understand the implications of this change for occupational health, it is intended to: a) characterize the population of older workers in a municipality in Portugal with respect to their capacity for work; b) comparing a sample of older workers with another sample of workers aged less than 35 years.
Method: This is a descriptive, correlational, comparative cross-sectional study, carried out after the application of a survey of workers in Albufeira municipality, with 1301 individuals. To obtain the final sample, the age-stratified sampling method was used. The study was authorized by the municipal responsible and the workers’ participation complied with all ethical requirements.
Results: The sample of Older Workers is less educated, has less differentiated jobs and maintains gender balance, something that does not happen in the younger ones where the females are more prevalent. When comparing work capacity, there is an increase in morbidity and disability in the older age group, as well as a more negative feeling associated with the current intrinsic capacity, the capacity to face the demands of the task, and the available psychological resources. There is also a higher rate of long-term absenteeism and limitations in sensory perception (visual and auditory) that affect work capacity, factors that put them in a situation of greater vulnerability towards the Young Workers.
As far as the environment and interpersonal relationships are concerned, they believe that the employer values less their work than the other rest, and they are the only ones who report the existence of bad or very bad working environments. However, they do not present many suggestions for improvement.
Regarding the idealize retirement age, it exists a direct relationship with work ability (assessed with the WAI- work ability index) although they seem to be poorly informed about measures that could potentially facilitate and promote their physical and mental health, as well as their working capacity. However, they suggest increasing the number of holidays/ days off as facilitators.
Conclusion: The study concluded that there are statistically significant differences in almost all the areas analyzed, with detriment to older workers. It is therefore urgent to rethink new solutions in order to ensure in the future the maintenance of its productive capacity in a healthy and lasting way.

BARRIER CREAMS AS PREVENTION/ MITIGATION OF SOME OCCUPATIONAL DERMATITIS

Introduction/ framework/ objectives: The occurrence of occupational contact dermatitis is of reasonably frequent due to acute or chronic contact with various chemical agents, sometimes enhanced by moisture. The purpose of this review was to acquire more knowledge about the characteristics of barrier creams, as well as the role they can play in Occupational Health, especially in tasks where the use of gloves may be contraindicated.
Methodology: This is an Integrative Bibliographic Review, initiated through a survey conducted in June 2018 in the databases “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina, Academic Search Complete and RCAAP “.
Content: Some of the agents associated with contact or irritation dermatitis are solvents and other petroleum derivatives, as well as detergents. It is believed to account for about 90% of occupational dermatitis. Symptoms may impair the ability to work and, if the situation becomes chronic and/ or intensified, it may justify the change of job and the declaration of suspected occupational disease.
Conclusions: In jobs with severely harsh chemical agents, especially if moisture coexists, it is reasonably common for some more sensitive employees to develop occupational dermatitis of varying severity. In most situations it is possible to use gloves, which drastically reduces the amount of product that comes into contact with the skin, except if it enters by the cuff and the glove gives occlusion, which will increase the absorption; in these circumstances it may be appropriate to use suitable material sleeves, unless these and/ or the gloves significantly potentiate the sweating, thus disturbing the good condition of the skin. For these situations, barrier creams re recommended, however, their role is not consensual, since some researchers claim that they may increase contact with chemical occupational agents (by retention) and/ or not be used in a frequency or quantity where its effectiveness can be verified. It would be very pertinent to develop investigations that evaluate the national reality, with robust methodology and adequate technological resources.